WORKING AT HEIGHTS
OHS-PR-09-15-F13(A) RESCUE PLAN (RP)
Operating Area: Central Operating Departmen
Projects Department Central/Qassim Division
Area t:
Project Name: Reinforcement of 132 kV SS 8919 & SS 8922 Hail
Contractor Name: Project Contract
AL NOWAISER SUB STATION 4400013133
Type: No.:
Prepared by: Reviewed by: Approved by:
Engr. Muhammad Zakria Engr. Mohamed Adel Engr. Tarek Abu Taleb
Khan Abou Ghaly
Safety Officer/Engr. Site Manager Project Manager
OHS Forms Procedure Reference Revision Number Revision Date Approved By
FALL PROTECTION PLAN (FPP) OHS-PR-09-15-F13(A) 0 MAY 2021 OHSMS - WOA
WORKING AT HEIGHTS
OHS-PR-02-15-F05(A) WORKING AT HEIGHTS RESCUE
PLAN
Operating Area: Central
Departmen
Operating Projects Department Central/Qassim Division
t:
Area
Project Name: Reinforcement of 132 kV SS 8919 & SS 8922 Hail
Project Contract
Contractor Name: AL NOWAISER SUB STATION 4400013133
Type: No.:
WORKING AT HEIGHTS RESCUE PLAN
132 kV SS 8919 &
Rescue Plan Ref No: WAH-000-2023
Work Site: SS 8922 Hail
Location/area: Buildings, Basement, Tunnels, Roof Top
JOB TASK:
Reference No: WAH-000-2023
Work at Height Dates: From: 20-07-2023 To: 19-01-2024
What is task to be done: GIS Erection, GIB Erection, Foundation shuttering / de shuttering, concrete
pouring, conduit pipe installation, Door installation, Scaffold Erection / Modification / Dismantling,
Painting works, Gas filling, Installation of Cable Tray & Support, Installation of Fire Fighting System,
Installation of HVAC System, Cable Pulling, Cable glanding.
Operators:
Names of operators who are involved in the work at height:
1) –MOHAMMED ASIF 2)- AMEER HAYAT
3) - ASSAD KHAN 4)- NISSAR AHAMED
5)- SHAHID ALI 6)- Badsha Khan
The Rescuer is to check all individual suspension trauma straps are in good working condition prior to
proceeding with the work at height task and sign below.
7) Signature WAH Rescuer: Mr. Mohamed Ade Abou Ghaly Date: 20-07-2023
(Working at Heights (WAH) Rescuer to remain with operators at all times for safety and
communications)
RESCUE:
Communication:
What communication systems will be used between the suspended worker and supervisor / rescue team?
( as appropriate)
1) Direct voice ☒
communication
2) Whistle ☒
2) Mobile Phone ☒
3) Two-way Radios / ☐
Page 1 of 10 Rev.2 [08-April-2019] Projects Business Unit
Headsets
Page 2 of 10 Rev.2 [08-April-2019] Projects Business Unit
Emergency Contact:
In the event of an emergency / fall from height the WAH supervisor should immediately alert:
The rescue team and first aid assistance:
Rescue Team Name: Husan Mohey Name: Mohamed Adel
Abou Ghaly
Name: Syyed Ali
First Aider(s) Name: Hussan Mohey Name: Inamullah
Name: Qaiser Imran Name: …………………
If the site rescue team is unable to affect a rescue within 5 minutes the Fire & Rescue Service and the
Ambulance Service are to be called on 🗌: 050 346 1547
Local Accident & Emergency Hospital 🗌 – Modern General Hospital Al Hait
In all instances inform the Control Room of the situation, 🗌: ……………………………………….
N.B. Once the rescue team is in attendance and if required, a nominated person is to go to the
site entrance to meet, and direct the emergency services, and provide the following information:
What type of structure and how high up is the casualty: GIS, GIB, Foundation column, Concrete Pouring
Scaffold – 4 m
Climber / Technician condition after fall: ..…………………………………………………………………………………..
Safety of Rescuers:
( as appropriate)
Are Operators trained competent & in date in use of rescue equipment? Yes ☒ No ☐
Are Rescue training records in date? Yes ☐ No ☒
Are there a sufficient number of rescuers available? Yes ☒ No ☐
Is rescue equipment selected appropriate for nature of work? Yes ☒ No ☐
What obstructions are in the way of reaching the suspended Operator? (Detail): GIS or other permanent
equipmets
…………………………………………………………………………………………………………………………………...
…………………………………………………………………………………………………………………………………...
Have assessments been made of anchor points, & are they in date for test? Yes ☒ No ☐
Has consideration been made to method of attaching casualty? Yes ☒ No ☐
(Detail):………………………………………………………………………………………………………………………...
………………………………………………………………………………………………………………………………….
How will rescuers get to casualty?
( as appropriate) ( as appropriate)
Rescue ladder.………..…………………………….. ☒ Rescue Kit…..................................................................☐
Page 3 of 10 Rev.2 [08-April-2019] Projects Business Unit
Building & roof..…………………………………….. ☐ Elevator / Goods Lift..................................................☐
Climb/abseil down building/structure/tower..……. ☐
Suspended access equipment…...........................☐
Aerial equipment from ground……………………. ☒ Crane man basket…...................................................☐
What equipment is needed to ensure rescue within 5 minutes in order to minimize suspension trauma?
( as appropriate) ( as appropriate)
Rescue ladder...…………………………………….. ☒ Aerial ladder truck......................................................☐
Remote Rescue Kit...………………………………. ☐ Suspended access equipment..............................☐
Climbing / rope rescue system..…………….……. ☐ Safety Ropes................................................................☐
Crane man basket………….……………….……… ☐ Stretcher........................................................................☒
MEWP.……………….………………………..…….. ☒ Toxic shock strap......................................................☐
Pneupac Resuscitator….…………….………….... ☐ First Aid Kit....................................................................☒
If Operative is injured
( as appropriate)
Can casualty still be rescued within 5 minutes? Yes ☒ No ☐
Is a qualified first aider who under stands suspension trauma present? Yes ☐ No ☒
Who and how will the emergency services and hospital be alerted? (Detail): Area supervisor will inform to
the site rescue team and rescue team will proceed to the hospital.
How will others be protected?
( as appropriate) ( as appropriate)
Assign someone to direct traffic.………………….. ☒Set up barriers................................................................☒
How will Accident scene be protected?
( as appropriate) ( as appropriate)
Prevent further injury or damage.………………….. ☒........................................................................Set up
barriers ☒
Preserve wreckage………………………………….. ☒ Report Incident / Event in normal manner….......☒
Other Considerations:
Lone working precautions (Detail): No one is allowed to work alone.
Unusual features of building / structure / tower (Detail): N/A…………………………….……..
………………………....
…………………………………………………………………………………………………………………………………...
Weather Conditions (Detail): Rain or Wind …………………………………………………..…….………………….....
…………………………………………………………………………………………………………………………………...
Proximity to emergency services / hospital (Detail): – Modern General Hospital Al Hait – 1.5 km ……….
Page 4 of 10 Rev.2 [08-April-2019] Projects Business Unit
Authorising Manager: APPROVAL OF Signature:
Signature: WORKWORK AT HEIGHT
AT HEIGHT Language
PLAN:barriers
RESCUE
RESCUE (agency / BY:
PLAN PRODUCED contract sta
………………………………………………………… ……………….....
Name (print):…MohamedWork Ramdan
At HeightKawareRescuer In Charge:
Supervisor:
Name (print): Abdul Fattah ………………………………………………………
Signature:……… …………… Name (print):…Syyed Ali
...
...........
…………
Position: Project Manager Date:… 20-0…: 7-
Position …20
Fall protection
…
Supervisor
23……………………
Date:…… 20-07-Date:……20-07-
Position : Site
2023……
2023……………………………. Engineer
Work at Height Rescue Plan
Introduction
When operatives are suspended in mid-air after a fall, their lives hang in the balance - even if they
have survived the fall without a scratch. Every second counts. The intention of this guidance is to help
you fully understand the implications of an operative falling, being arrested and then suspended by a
harness, which initially saves them, but minutes later may kill them due to suspension trauma.
More than just helping to understand why this happens, this guidance will show what action should be
taken to prevent a fallen operative dying from suspension trauma. It will also clearly outline the current
law with which must be complied with to discharge our legal responsibility.
Page 5 of 10 Rev.2 [08-April-2019] Projects Business Unit
How Soon to Death or Serious Injury?
Harnesses can become deadly whenever an operative is suspended for durations of over five minutes in
an upright posture with the legs relaxed straight beneath the body. After five minutes they are highly
likely to be unconscious - but operatives attending the scene may not realise the seriousness of the
situation and, 15 minutes later a dead body could be hauled up. The cause of this problem is called
'suspension trauma'.
In March 2004, OSHA (US equivalent of the UK Health and Safety Executive) issued a health and safety
bulletin outlining the dangers of prolonged, upright suspension. The bulletin warned of the risk of
"orthostatic intolerance" and
Page 6 of 10 Rev.2 [08-April-2019] Projects Business Unit
"suspension trauma" and refers to some of the potential health hazards - death being the chief one -
experienced by operatives who are suspended upright by fall arrest equipment after a fall.
Suspension Trauma – Orthostatic Intolerance
Unless the operative is rescued promptly using established safe procedures, suspension trauma caused
by orthostatic intolerance could occur and result in serious or fatal injury as the brain, kidneys and
other organs are deprived of oxygen. Most users of fall protection equipment are unaware of the
hazard of suspension trauma.
Venous pooling - The need to faint and fall over
Death from suspension trauma is caused by orthostatic intolerance and is the result of venous pooling.
This can occur any time a person is required to stand still for prolonged periods and may be worsened
by heat and dehydration. Major blood vessels pass through the muscles in the legs. The movement of
these muscles assists circulation by squeezing the blood back up towards the heart. If the muscles stop
moving, gravity pulls the blood down into the legs.
Eventually, enough blood accumulates (venous pooling) so that return blood flow to the right chamber
of the heart is reduced as the heart can only pump the blood available, so its output begins to fall. The
heart then speeds up to maintain sufficient blood flow to the brain but, if the blood supply to the heart
is restricted enough, the higher pulse and faster breathing is ineffective and the body abruptly slows
the heart. The result is fainting.
The moment a person loses consciousness they collapse and become horizontal so the time spent in a
vertical position while unconscious is minimal and, as blood flow improves - the result of being
horizontal - the person returns to consciousness and recovery is likely to be rapid.
When a person is suspended in a harness in which their legs are immobile, unlike fainting, the
person does not or cannot naturally move into a horizontal position, then gravity pulls blood into
the lower legs.
In a harness, the operative can't fall into a horizontal posture, so the reduced heart rate causes the
brain's blood supply to fall below the critical level. During excessive venous pooling, cardiac output and
arterial pressure fall to levels, which can critically reduce the quantity and/or the quality of oxygenated
blood flowing to the brain.
Three things that occur which aggravate the problem:
⮚ 1 - the operative is suspended in an upright posture with legs dangling.
⮚ 2 - the safety harness straps exert pressure on leg veins (femoral arteries),
compressing them and reducing blood flow back to the heart.
⮚ 3 - the harness keeps the operative in an upright position, regardless of loss of consciousness
Loss of consciousness assures that a suspended person will not be moving their limbs; so venous
pooling will increase which will in turn reduce the circulating blood volume even further.
This includes not only a potentially fatal reduced blood flow to the brain, but also the other vital
organs, such as the kidneys. The kidneys are highly sensitive to blood oxygen levels and renal failure
as a result of excessive venous pooling is a real possibility.
Injuries suffered during the fall, or the shock resulting from the experience of the fall, can increase the
onset and severity of venous pooling and orthostatic intolerance, as can physical and environmental
factors such as fatigue, dehydration, hypothermia, cardiovascular disease, respiratory disease and
blood loss. The time spent in an unmoving suspended position, with the legs below the heart, is what
kills.
The Need for a Rescue Plan
Operatives face considerable danger after a fall, through the lack of a thought-out, detailed and fully
implemented rescue plan. It is now a legal requirement of the ‘Work at Height Regulations 2005’ to
have a rescue plan. The best rescue strategy is to take every possible precaution to prevent operatives
from falling in the first place.
Page 7 of 10 Rev.2 [08-April-2019] Projects Business Unit
But the reality is that falls happen, and a rescue plan is an essential component of the overall fall
protection method statement and risk assessment. The lack of any form of a pre-conceived post-fall
rescue plan not only puts the fall victim at risk but also puts rescuers in harm's way. Whenever there
are unplanned attempts to rescue, second or third injuries or fatalities may not be uncommon.
Page 8 of 10 Rev.2 [08-April-2019] Projects Business Unit
Critical Phases of Rescue
The responsibility to have a post-fall rescue system in place lies with TWS as the employer, below are the
four critical phases of rescuing a suspended operative:
1. Before the fall
2. At fall arrest
3. Suspension
4. Post-fall rescue
Each phase presents unique safety challenges. Suspension trauma can be influenced by all aspects of
the fall, so they are all equally important. As with many aspects of safety, increasing the safety in one
phase can compromise safety in the others. Whatever training operatives have received will determine
how they respond to different phases.
1. Before the fall
The key issue of fall protection prior to a fall is compliance. If a harness is too uncomfortable, too
inconvenient or interferes too much with task completion, operatives may not use the equipment or
may modify it (illegally) to make it more tolerable.
A second major point is how far an operative falls before his fall is arrested. The greater the fall, the
greater the stress on the body when the fall is arrested. The longer the lanyard the longer the fall
distance, however, the shorter the lanyard, the more often it will have to be repositioned when
operatives are mobile. Restraint lifelines are the preferred method of working because it allows
maximum flexibility. Working in restraint prevents the operative from falling, yet should a fall occur
the arrest distance is kept to a minimum (limited fall).
2. At fall arrest
The whole concept of fall protection is that operatives who fall will be stopped by a tethering system.
Unfortunately, the posture of the falling operative is unpredictable. Depending on the harness
attachment point and the position of the operative's body at fall arrest, different harness attachments
offer different advantages. An attachment near the shoulders means that any drag from the lanyard will
serve to position the operative's body in an upright position so the forces are distributed from head to
foot. The head is somewhat protected if the legs and body precede it in the fall, but this offers some
disadvantages after the fall arrest is completed
3. Suspension
It is natural to assume that once a fall has been arrested then the fall protection system has
successfully completed its job. Unfortunately, this is not the case. An operative suspended in an upright
position with the legs dangling in a harness of any type is subject to suspension trauma and orthostatic
intolerance.
Fall victims can slow the onset of suspension trauma by pushing down vigorously with the legs, by
positioning their body in a slight leg-high position or, by standing up. Harness design and fall injuries
may prevent these actions.
4. Rescue
Rescue must come rapidly to minimise the dangers of suspension trauma. The circumstances together
with the lanyard attachment point will determine the possibility of self-rescue.
In situations where self-rescue is not possible, operatives must be supervised at all times. Regardless
of whether an operative can self-rescue or must rely on others, time is of the essence because an
operative may lose consciousness in only a few minutes.
For conscious casualties it is recommended (where possible) that the suspended person keep their legs
moving to keep the blood pumping and reduce the risk of venous pooling.
Death by Rescue - "Toxic Shock"
If an operative is suspended long enough to lose consciousness, rescue personnel must be careful in
handling such a person or the rescued operative may die. The blood which has pooled in the legs is
Page 9 of 10 Rev.2 [08-April-2019] Projects Business Unit
prevented from collecting oxygen from the lungs and becomes stale, as it is starved of oxygen, then
becomes loaded with carbon dioxide and is contaminated with toxins, the result of the body's
metabolizing processes.
Page 10 of Rev.2 [08-April-2019] Projects Business Unit
10
If the casualty is laid down during the rescue, the stale blood rushes back to the heart and vital organs.
This rush of de- oxygenated and toxic blood can cause death by heart attack or, a few days later, of
organ failure. Current recommended procedures following a rescue are to keep the casualty in a knees-
bent 'W' sitting position for 30 to 40 minutes before moving the casualty to a lying down horizontal
position. This action partially closes the femoral artery allowing any pooling of blood to be slowly
released back towards the heart. The blood is then able to be re-processed, preventing orthostatic and
toxic shock.
Note: Normal first aid rules don't apply in cases of rescue trauma. It is vitally important that emergency and
medical personnel do not allow the casualty to lie down or transfer the casualty to a stretcher before allowing any
pooling of blood to be slowly released back towards the heart.
What to look out for - If a worker is suspended in a harness
The possible signs and symptoms of orthostatic intolerance can start to be seen in 2/3 minutes and can
include:
⮚ Faintness
⮚ Nausea
⮚ Breathlessness
⮚ Dizziness
⮚ Sweating
⮚ Unusually low heart rate
⮚ Unusually low blood pressure
⮚ Paleness
⮚ Hot flushes
⮚ Skin tone may appear grey in colour
⮚ Loss of vision
⮚ Increased heart rate
Owing to the possibility of damage to vital organs - the result of suspension trauma - it is
recommended that all recovered casualties should be taken to their nearest Accident & Emergency
Unit for examination and observation.
Rescue Plans
Rescue plans don't have to be complex, but should include procedures for:
⮚ Preventing prolonged suspension
⮚ Performing rescue and treatment as quickly as possible
⮚ Identifying orthostatic intolerance signs and symptoms
Management's reasonability for safety needs to give careful consideration to the methodology of rescuing
a fallen operative. Such considerations might include:
Dialling Emergency No. :……911………………………………..
It is often thought that the word 'rescue' means calling911, but calling the Local Area Fire & Rescue
Service does not constitute an effective rescue plan.
Crane Man Basket
This option has severe limitations, the main one being time. Target time from 'Man Down' to being
recovered needs to be no more than five minutes. Other restrictions and shortcomings that make
this a less than ideal solution are:
⮚ The crane is out of action for some reason, e.g. it may be 'winded-off'.
⮚ The driver may be away from the crane.
⮚ Rescue by crane is limited to building façades and often is not able to provide
access and rescue internal to the structure.
⮚ The crane man basket may be in the wrong location.
Page 11 of Rev.2 [08-April-2019] Projects Business Unit
10
Mobile Elevating Work Platform (MEWP)
Page 12 of Rev.2 [08-April-2019] Projects Business Unit
10
This option for rescue can have its limitations such as available access and height restriction as
the casualty may be at a height greater than the reach of the MEWP.
Rope Access Rescue
Rope rescue requires a technical competency, which demands a high level of training and re-
training to acquire and retain this skill set. Given the limited time to complete a rescue, trained
rope rescue personnel would need to be on stand-by and within close proximity to any incident.
Donning the necessary kit to carry out a rope rescue can also be time consuming given that
every minute the casualty is hanging is critical. Perhaps the greatest restriction is that it is a skill
to which only a few would, or could, be trained.
Third Party Rescue Systems
There are a number of considerations to take into account when considering third part rescue
systems. In every consideration TIME is the critical factor and should be done as quickly as
possible, but 100 percent safe for the rescue crew. The speed with which the system can be
deployed and the rescue carried out is vitally important, as is the SIMPLICITY and EASE of use so
that a typical operative can deploy and carry out a rescue after being trained.
Remember:
Whichever methodology is chosen, the target time should be to rescue the casualty in under five
minutes.
Planning for Fall Protection must include Rescue
Having a rescue plan is just as important as having a fall protection plan. No site should have one
without the other. Just putting together a fall protection program without rescue is only doing half the
job.
The onus is on Management to ensure that the suspended operative is rescued quickly. That means
ensuring that for anyone who is working at height, there's a rescue plan. Fall protection must include an
emergency rescue plan.
How will the rescue of an operative who has fallen and is suspended in a fall-arrest system be
conducted? By answering some basic questions can help in developing a rescue plan.
The following questions require answers:
⮚ If an operative's fall is arrested can they be rescued in under five minutes?
⮚ How will you know that someone has fallen?
⮚ Will someone see it happen?
▪ Co-workers
▪ Business Partners
▪ Contractors
▪ Members of the public
⮚ What communication systems will be used between the suspended operative
and the rescue team?
⮚ How will the operative call for help?
▪ Voice
▪ Whistle
▪ Mobile Phone
⮚ Who will the Co-worker call?
▪ Nearest co-workers
▪ Supervisor
▪ Site Management
▪ Fire /ambulance where available
⮚ Is information available? Who and how will it be
Page 13 of Rev.2 [08-April-2019] Projects Business Unit
10
communicated?
▪ Emergency phone numbers
Page 14 of Rev.2 [08-April-2019] Projects Business Unit
10
▪ Site address
▪ Directions and access for ambulance/fire vehicle
or
other emergency services
▪ Which floor/how high up
▪ Operative's condition after fall
⮚ How will the safety of the rescuers be
assured, as well as that of the suspended
operative?
▪ Are operatives trained and competent in the use of rescue equipment?
▪ Is there sufficient number of trained personnel onsite?
▪ Are rescue-training records kept up-to-date including any re-assessments?
▪ Is the rescue equipment selected appropriate for the nature of the work?
▪ What obstructions are in the way reaching the suspended operative?
▪ Have assessments been made of anchor points?
▪ Has consideration been given to the method of attaching to the casualty?
⮚ How will rescue workers get to the casualty?
▪ Rescue Ladder System
▪ Rescue Haul System
▪ Keys to building and roof
▪ Elevator
▪ Pull casualty in through window or balcony
▪ Climb/abseil down the building/structure/tower
▪ Aerial equipment from ground
▪ Suspended access equipment
▪ Crane Man Basket
⮚ How will rescue be assured within five minutes of the occurrence of a fall to minimize the risk of
further injury or death due to suspension trauma? And, what rescue equipment is needed?
▪ Rescue Ladder
▪ Rescue Haul System
▪ Toxic shock strap
▪ Suspended access equipment
▪ Ropes
▪ Aerial ladder truck
▪ MEWPS or scissor lift
▪ Climbing/rope rescue equipment
▪ Crane Man Basket
▪ First aid kit
▪ Stretcher available should casualty be seriously injured
⮚ What if the operative is injured?
▪ Can the casualty still be rescued within five minutes?
▪ Is there a qualified first-aider who understands suspension trauma and knows how to treat
it?
▪ Who and how will the emergency services and hospital be alerted?
⮚ How will others personnel be protected?
▪ Assign someone to direct traffic
▪ Set up barriers
⮚ How will the accident scene be
protected?
▪ Prevent further injury or damage
▪ Set up barriers
▪ Preserve wreckage
▪ Aid investigation later
⮚ Are there other considerations?
▪ Working alone
▪ Language barrier
Page 15 of Rev.2 [08-April-2019] Projects Business Unit
10
▪ Unusual features of building/structure
Page 16 of Rev.2 [08-April-2019] Projects Business Unit
10
▪ Wind
▪ Other hazards
▪ No emergency services nearby
▪ Distance from rescue teams
Warning!
An operative who has suffered a fall and is suspended in his harness is a true medical emergency. Just
because they are hanging in a harness doesn't mean there is plenty of time to perform a rescue.
Rescue has to be planned, practiced and performed quickly and effectively or the victim may very well
die before the rescue finally occurs.
Practice can save lives
Perhaps just as important as having a rescue plan in place is practicing the plan before a real-life fall
occurs. The new Working at Height Regulations state that a rescue procedure must be in place and
practiced on a regular basis and competence maintained and recorded.
Are we breaking the Law on site without knowing it?
Before any work at height can commence on site the following provisions must be in place as a minimum
legal requirement:
⮚ There must be a rescue plan and procedure.
⮚ The operatives are trained and competent in use of rescue equipment.
⮚ Sufficient number of trained and competent personnel on site.
⮚ The rescue procedure in place is practised on a regular basis and competence is maintained on
record.
⮚ The selection of rescue equipment needs to be appropriate for the nature of work.
Page 17 of Rev.2 [08-April-2019] Projects Business Unit
10